Gastroparesis and enterolab results

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lorinluv
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Gastroparesis and enterolab results

Post by lorinluv »

I learned something today. After gastric bypass in 2004, I had a leak in "new" tummy following surgery, and because of my size /difficulty of surgery, it was decided to leave feeding tube in and let heal on its own, which took 3 months. When feeding tube was removed, I couldn't keep food down, this was a sincere struggle for 1 1/2 years. When my body ran out of stored fuel, brain function got severe, I didn't recognize people I had known for years, etc. docs couldn't figure it out, so finally I made myself eat the tiniest bits of food and lay down and refuse to give it back / throw up. After a month, I saw great improvements and began to regain / repair brain functions. Over the years since, I have always threw up often, and came to accept it as unexplainable, then today reading through posts about nausea, I see a post mentioning gastroparesis, and BAM.... there's what my surgeon didn't know. Of course it doesn't change anything, but nice to have that puzzle piece, thank u.

Enterolab results were unremarkable, gluten 8, milk 1, egg 4, soy 2, mean value of 2

I have been artificial sweetener free for 2 weeks now and will begin phasing out gluten next I suppose.

Again, feels good not to be alone. Diarrhea continues *sigh*
Lauria F
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humbird753
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Post by humbird753 »

Hi Lauria,

It makes sense that you would feel good at least to have a name to something that has caused you problems for so long.

BTW, your Enterolab test results are amazingly low.

I see you're fairly new here - Welcome! And good wishes to you on your journey to regaining your health.
Paula

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"Life is not about waiting for the storm to pass... It's learning to dance in the rain."
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Post by brandy »

wow Lori, you have been through a lot. Perhaps Tex can chime in on your Enterolab scores.

Anyways, do not get discouraged. MC healing can take awhile. We are talking months here not weeks and days. Younger folks have an edge and heal faster.

You are at the right place.
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tex
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Post by tex »

Lauria,

Yes, I believe that gastroparesis is somewhat common with MC, despite the fact that it's not mentioned in the official medical description of the disease. For most of us who have to deal with it, I believe that it's due primarily to magnesium deficiency because magnesium deficiency is very common and causes major problems for MC patients. Adequate magnesium is necessary for proper muscle functioning. Magnesium relaxes muscles, and without sufficient magnesium, muscles tend to clinch/cramp up. The pyloric sphincter at the bottom of the stomach is a muscle of course, and if it isn't able to properly relax when it's time to discharge chyme (partially digested food), gastroparesis is the result. The medical community blames gastroparesis on damage to the vagus nerve (either because of surgery or diabetes), but I believe that they are wrong. It's the magnesium deficiency associated with diabetes (or the magnesium deficiency caused by the stress of surgery in some cases) that actually causes the nerve damage that leads to muscle malfunction that results in gastroparesis. Stress depletes magnesium. Magnesium deficiency causes nerve damage. Here's a description of the mechanism by which I believe gastroparesis occurs (from pages 26–27 in chapter 3 of the book Pancreatic Cancer — A Guidebook for Prevention:
Gastroparesis (slow stomach emptying) is a common problem with diabetes.
It's a serious problem for almost a third of diabetes patients because it can cause nausea, acid reflux, and other problems, and doctors seem flummoxed by this issue. But it is likely that researchers will some day show that gastroparesis is typically caused by magnesium deficiency. Muscles cannot perform properly without adequate magnesium. They cannot relax, and they tend to spasm and develop tremors.

The pyloric sphincter is located between the stomach and the first segment of the small intestine (known as the duodenum). The pyloric sphincter is regulated by the enteric nervous system to allow chyme (partially digested food) to flow from the stomach into the small intestine as the stomach completes it's part of the digestive process. The adverse effects of magnesium deficiency on the central nervous system are well known and there's no obvious reason not to attribute the same association to the enteric nervous system (Langley, & Mann, 1991).29 The enteric nervous system, sometimes called the second brain, controls the digestive system and correlates information between the digestive system and the brain.

This particular observation does not seem to have been explored by medical researchers, so there is no published medical proof of this theory, but it seems apparent that a magnesium deficiency would be very likely to interfere with the proper functioning of the pyloric sphincter. And compromised functioning could prevent it from allowing the stomach to empty properly as chyme is ready to be passed into the small intestine. Chyme that remains in the stomach too long tends to ferment in the warm, moist environment, producing gas and pressure that can cause nausea.

This can also cause acid reflux and gastroesophageal reflux disease (GERD) because if the pyloric sphincter cannot function properly because of a magnesium deficiency, then the lower esophageal sphincter between the esophagus and the stomach probably will not function well enough to prevent acid reflux, either. And we already know that diabetes is closely associated with magnesium deficiency. Therefore, to resolve a gastroparesis problem, most diabetes patients probably simply need magnesium, rather than the drugs that most doctors prescribe to treat the problem.
Here's reference 29 from that quote:

29. Langley, W. F., & Mann, D. (1991). Central nervous system magnesium deficiency. Archives of Internal Medicine, 151(3), 593-596. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/2001142

Regarding your low EneroLab test scores:

1 in 500 people in the general population have selective IgA deficiency, (the inability to produce normal amounts of immunoglobulin A). For people who have selective IgA deficiency, the tests used for such purposes as celiac screening blood tests, and stool tests for food sensitivities, will tend to yield false negative results (readings that are too low, because of the inability to produce normal amounts of IgA antibodies).

There is a simple blood test that your doctor can order to rule out selective IgA deficiency. You may have already had the test. If you have, and your result was normal (that is, confirmation that you do not have selective IgA deficiency), then the EnteroLab test result is accurate, and you are not sensitive to any of those foods. However, if you have selective IgA deficiency, then the EnteroLab test results (and any celiac screening blood tests your doctor may have ordered) will not be reliable — IOW they will almost surely be false negative results.

I hope that some of this is helpful.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
lorinluv
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Post by lorinluv »

Unsure of the application, but I had the roux en y, which bypasses that pyloric sphincter , so in essence I don't have one. Does that mean gastroparesis isn't possible in my digestive tract?

Could I have been magnesium deficient for all these years without a test picking that up?

Thanks to all of u for the kind supportive words, they mean the world to me
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tex
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Post by tex »

Yes, with that version the food bypasses the pyloric sphincter. However, the gastric digestive juices do not. So if the pyloric sphincter is not working correctly, those digestive juices may not be available (in sufficient amounts) to the food when needed, after it enters the jejunum, resulting in poor digestion. One of the known issues with that type of surgery is indigestion, because digestion cannot proceed normally in the small pouch formed from the top of the stomach.

The human body is very adaptive. My colon was removed almost 7 years ago, but it didn't take long (less than a year) for my digestive system to adapt so that motility was reduced to allow a longer transit time in the small intestine. This allows my small intestine to remove (recycle) more water than it normally would. But the body cannot adapt to correct a magnesium deficiency.

And yes, it's certainly possible that you may have been magnesium deficient for many years without it being detected by any doctor. I apparently had a chronic magnesium deficiency for most of my life (up until about a year and a half ago). Most people in the general population are magnesium deficient these days (because of food produced in soils depleted of magnesium), and the percentage is higher for IBD patients because IBDs (including MC) deplete magnesium. In addition, all corticosteroids (including budesonide) deplete magnesium. Alcohol depletes magnesium. Coffee depletes magnesium. Our paleo ancestors didn't use any of that stuff, so they had plenty of magnesium in their systems. We have to take a significant magnesium supplement or our health heads south.

In my own case, the signs were there, but I didn't know what they meant. Neither did any of my doctors. All my life (until my MC symptoms began), I was usually constipated (which is a symptom of chronic magnesium deficiency). 6 and 7 years ago I had a couple unexplained TIAs. I'm now convinced that they were caused by my chronic magnesium deficiency. A couple of years ago I had a couple of kidney stones (also a symptom of a chronic magnesium deficiency) and my doctors didn't have a clue why.

In the spring of 2015 I had to take repeated antibiotic treatments for some dental work and that depleted what was left of my meager magnesium reserves. I even went to the ER with tachycardia, erratic blood pressures, poor body temperature regulation, and breathing problems (I couldn't take a deep breath). The doctors didn't have a clue what was wrong with me and they sent me home. But when I checked the lab test results later, the results showed that my magnesium level was low (it was even flagged). The doctors didn't even recognize it as a problem. :roll:

Now that I've resolved my chronic magnesium deficiency, my blood pressure is down (low for my age), my heart rate is normal, I don't get overheated easily, no more foot/leg cramps, or unexplained muscle pains, and I can take a deep breath whenever I want. For the previous 10 years (as my symptoms became worse), I couldn't take a deep breath.

Our doctors are not trained to recognize magnesium deficiency. Because they are not trained to look for it, it's not even on their radar, so they never see it, no matter how bad a patient's symptoms may be. And the serum magnesium tests they use to check magnesium levels is worthless because less than 1 % of the body's magnesium supply is in blood serum, and the body keeps that level in the normal range because magnesium is a vital electrolyte. So that test won't even detect a magnesium deficiency until the body is dangerously low on magnesium reserves.

It took almost a year to get rid of my most persistent symptom, but after I rebuilt my magnesium reserves this finally resolved the breathing problem that I had been dealing with for 10 years. The breathing problem was similar to having asthma except that there was no wheezing. Doctors thought I was nuts when I asked them about the problem. But getting rid of my chronic magnesium deficiency finally got rid of that symptom and now I can breathe normally again. And yes, that's a known symptom of magnesium deficiency (but apparently not known to most doctors).

So yes, it's possible to have a chronic magnesium deficiency that's never discovered by any of your doctors. They simply are not trained to look for the problem, even though it's all around them.

I hope that some of this is helpful.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
lorinluv
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Post by lorinluv »

Is there a magnesium test other than serum?
Lauria F
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tex
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Post by tex »

Yes. Ask for the RBC (Red Blood Cell) magnesium test. It's still a blood test, but it tells you how much magnesium is stored in cells in the body, and that's what you want to know. But remember to not take any magnesium supplement on the day of the blood draw, before the draw, because taking a supplement before the draw will temporarily increase the level.

The increase will probably only be slight for an RBC test, but it will be huge for a serum test. The only reason my serum test was below normal when I went to the ER that day is because I felt so sick that morning that I didn't take any supplements. If I had taken a magnesium supplement that morning I might still be deficient and wondering what's wrong with me.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by tex »

Here's verification of why the serum test used by most medical professionals is worthless. This is what the Magnesium Fact Sheet for Health Professionals published by the National Institutes of Health says about magnesium:
An adult body contains approximately 25 g magnesium, with 50% to 60% present in the bones and most of the rest in soft tissues. Less than 1% of total magnesium is in blood serum, and these levels are kept under tight control. Normal serum magnesium concentrations range between 0.75 and 0.95 millimoles (mmol)/L. Hypomagnesemia is defined as a serum magnesium level less than 0.75 mmol/L. Magnesium homeostasis is largely controlled by the kidney, which typically excretes about 120 mg magnesium into the urine each day. Urinary excretion is reduced when magnesium status is low.

Assessing magnesium status is difficult because most magnesium is inside cells or in bone. The most commonly used and readily available method for assessing magnesium status is measurement of serum magnesium concentration, even though serum levels have little correlation with total body magnesium levels or concentrations in specific tissues.
The red emphasis is mine.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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